May 2007
Volume 48, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2007
Post Transplantation Lymphoproliferative Disorder With Chorioretinal Involvement After Bone Marrow Transplant in a Child
Author Affiliations & Notes
  • S. Barile
    Ophthalmology, Hôpital Maisonneuve-Rosemont, Montréal, Quebec, Canada
  • G. Cordahi
    Ophthalmology, Hôpital Maisonneuve-Rosemont, Montréal, Quebec, Canada
  • R. Thibeault
    Infectious Diseases,
    CHU Sainte Justine, Montréal, Quebec, Canada
  • Y. Robitaille
    Pathology,
    CHU Sainte Justine, Montréal, Quebec, Canada
  • Footnotes
    Commercial Relationships S. Barile, None; G. Cordahi, None; R. Thibeault, None; Y. Robitaille, None.
  • Footnotes
    Support None.
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 3679. doi:
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    • Get Citation

      S. Barile, G. Cordahi, R. Thibeault, Y. Robitaille; Post Transplantation Lymphoproliferative Disorder With Chorioretinal Involvement After Bone Marrow Transplant in a Child. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3679.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose:: Epstein-Barr (EBV) associated post transplantation lymphoproliferative disorder (PTLD) has emerged as an increasing cause of high morbidity and mortality in solid organ and bone marrow transplant recipients, particularly in children. Clinical presentation is highly variable, however, chorioretinal involvement has been rarely described. We report a case of confirmed chorioretinal PTLD, CD20 negative, induced by EBV after hematological stem cell transplantation (HSCT) in a child and its response to radiation treatment.

Methods:: Seven months post HSCT a bilateral anterior non granulomatous uveitis associated with hemorrhagic chorioretinitis and a retinal detachment developed in a 8 year old girl. Serology was positive for CMV and EBV. Vitreous and retinal biopsies were performed during pars plana vitrectomy and quantitative PCR for EBV was realised on the vitreous fluid.

Results:: EBV-PCR on the vitreous sample revealed high viral load although it was negative in blood. The retinal biopsy showed a complete retinochoroidal infiltration by lymphoproliferative cells LMP-1 positive, but negative for CD20. In situ hybridization with Eber probe confirmed the presence of EBV. Treatment consisted of local radiation therapy (150 Gy). Five months later vision stabilized and chorioretinal infiltrates healed in both eyes without any complication related to treatment.

Conclusions:: Radiotherapy is an effective treatment for CD20 negative PTLD and must be considered as a treatment option in this kind of PTLD subtype mostly unresponsive to Rituximab.

Keywords: retina • tumors • uvea 
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